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SIGNpost 00703

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST *

Post00703 Global Hep Network + Abstracts + News 19 June 2013

CONTENTS
1. Global Hepatitis Network against ‘silent crisis’
2. Abstract: Needlestick injuries and safety syringes: a review of the
literature
3. Abstract: Transmission of hepatitis B virus from an orthopedic surgeon
with a high viral load
4. Abstract: Best strategies for global HCV eradication
5. Abstract: Research fatigue among injecting drug users in Karachi,
Pakistan
6. Abstract: Reduction in HCV Incidence Among Injection Drug Users
Attending Needle and Syringe Programs in Australia: A Linkage Study
7. Abstract: Law Enforcement Practices Associated with HIV Infection Among
Injection Drug Users in Odessa, Ukraine
8. Abstract: Update to Interim Guidance for Preexposure Prophylaxis (PrEP)
for the Prevention of HIV Infection: PrEP for Injecting Drug Users
9. Abstract: An alternative local anaesthesia technique to reduce pain in
paediatric patients during needle insertion
10. Abstract: Occupational hazards of interventional cardiology
11. USA: Multistate Investigation of Suspected Infections Following Steroid
Injections
12. News
– Got Needles? Why the Greatest Danger to Law Enforcement Isn’t Guns
– Assam India: Criminal case against transfusion of HIV-infected blood:
Gogoi
– Italy: Italy leads Europe in hepatitis C cases

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Highlights and news on Facebook: http://facebook.com/SIGN.Moderator

Selected updates at: http://twitter.com/#!/signmoderator
__________________________________________________________________
________________________________*_________________________________

1. Global Hepatitis Network against ‘silent crisis’
__________________________________________________________________
Global Hepatitis Network against ‘silent crisis’

By Johanna Morden, DEVEX.com (11.06.13)

www.devex.com/en/news/who-launches-first-global-hepatitis-network/81211

Hepatitis may not be as notorious a disease as HIV/AIDS, but it kills
almost as many people each year.

The World Health Organization, World Hepatitis Alliance and the Coalition
for the Eradication of Viral Hepatitis in Asia-Pacific (CEVHAP) unveiled on
Friday in Singapore the first Global Hepatitis Network to foster
international collaboration in stemming viral hepatitis, a deadly liver
disease said to afflict over 500 million people worldwide.

The network will help build capacity and strengthen national, regional and
global action in tackling viral hepatitis through:

* Raising awareness
* Promoting partnerships
* Mobilizing resources
* Evidence-based policy and data
* Prevention of transmission
* Screening, care and treatment

About 1.4 million people die each year of the disease linked to liver
cancer that comes in five types, according to new data from the Global
Burden of Disease Study.

Of these, over a million deaths occur in Asia-Pacific, a region that hosts
three times as many people dying from viral hepatitis as from HIV/AIDS each
year and nine times as many malaria deaths.

‘Silent crisis’

CEVHAP chair and co-founder Ding-Shinn Chen told Devex ahead of the launch
that the new Global Hepatitis Network marks a milestone in bringing much-
needed attention to the unfolding hepatitis “silent crisis” across the
globe.

“My hope is that the new commitment this network represents will lead to
governments adopting their own national strategies, with the support of
experts from within the network. A lot of this work of course requires
funding and that’s where CEVHAP is hoping that international donors and
nongovernmental organizations will play their part,” he said.

Chen called for reforms in addressing the killer disease in the areas of
improving available resources, extending existing HIV/AIDS frameworks to
viral hepatitis, and increasing access to medicines, which remains a major
challenge in developing countries.

Viral hepatitis, he explained, is a global problem, and its exclusion from
initiatives such as the MDGs “has pushed viral hepatitis to the fringes of
global health.”

“While malaria is rightly considered an African emergency, a silent crisis
is occurring in Asia-Pacific as a result of viral hepatitis,” added Chen.
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Needlestick injuries and safety syringes: a review of the
literature
__________________________________________________________________
Needlestick injuries and safety syringes: a review of the literature.

Br J Nurs. 2013 Apr 25-May 8;22(8):S4-S12.

Higginson R, Parry A.

Needlestick injuries are a serious concern for nurses and other healthcare
workers. One of the main clinical risks from needlestick injury is the
possible infection by blood-borne diseases, such as hepatitis and HIV.

A number of different measures have been introduced to minimise the risk
and impact of needlestick injuries, including the use of fixed-needle
safety syringes. However, some healthcare workers refuse to use such
devices, for reasons that include the perceived need to change syringe
needles between drawing up a medicine and its administration to a patient.

This paper will explore the literature relating to needlestick injuries and
the reasons commonly given for not using fixed-needle safety syringes.
http://www.ncbi.nlm.nih.gov/pubmed/23752503
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Transmission of hepatitis B virus from an orthopedic surgeon
with a high viral load
__________________________________________________________________
Transmission of hepatitis B virus from an orthopedic surgeon with a high
viral load.

http://www.ncbi.nlm.nih.gov/pubmed/23074317

Clin Infect Dis. 2013 Jan;56(2):218-24.

Enfield KB, Sharapov U, Hall KK, Leiner J, Berg CL, Xia GL, Thompson ND,
Ganova-Raeva L, Sifri CD.

Office of Hospital Epidemiology, University of Virginia Health System,
Charlottesville, VA 22908-0473, USA.

BACKGROUND: During the evaluation of a needle-stick injury, an orthopedic
surgeon was found to be unknowingly infected with hepatitis B virus (HBV)
(viral load > 17.9 million IU/mL). He had previously completed two 3-dose
series of hepatitis B vaccine without achieving a protective level of
surface antibody. We investigated whether any surgical patients had
acquired HBV infection while under his care.

METHODS: A retrospective cohort study of all patients who underwent surgery
by the surgeon was conducted. Patients were notified of their potential
exposure and need for testing, and samples with positive HBV loads
underwent DNA sequencing. Characteristics of the surgical procedures for
the cohort were evaluated.

RESULTS: A total of 232 (70.7%) of potentially exposed patients consented
to testing; 2 were found to have acute infection and 6 had possible
transmission (evidence of past exposure without risk factors). Genome
sequence analysis of HBV DNA from the infected surgeon and patients with
acute infection revealed genetically related virus (>99.9% nucleotide
identity). Only age was found to be statistically different between those
with confirmed or possible HBV transmission and those who remained
susceptible to HBV.

CONCLUSIONS: We documented HBV transmission during orthopedic surgery to 2
patients from a surgeon with HBV. This investigation highlights the
importance of evaluating individuals who do not respond to 2 series of HBV
vaccination, the increased risk of HBV transmission from providers with
high viral loads, and the need to evaluate the clinical practice of
providers with HBV and implement appropriate procedure-based practice
restrictions.
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Best strategies for global HCV eradication
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23286849

Liver Int. 2013 Feb;33 Suppl 1:68-79.

Best strategies for global HCV eradication.

Hagan LM, Schinazi RF.

Center for AIDS Research, Emory University School of Medicine and Veterans
Affairs Medical Center, Decatur, GA 30033, USA. lhagan2@emory.edu

Worldwide eradication of hepatitis C virus (HCV) is possible through a
combination of prevention education, universal clinical and targeted
community screening, effective linkage to care and treatment with promising
new direct-acting antiviral drug regimens.

Universal screening should be offered in all healthcare visits, and
parallel community screening efforts should prioritize high-prevalence,
high-transmission populations including injection drug users, prison
inmates and those with HIV/HCV co-infection.

Increasing awareness of HCV infection through screening, improving
treatment uptake and cure rates by providing linkage to care and more
effective treatment, and ultimately combining education efforts with
vaccination campaigns to prevent transmission and reinfection can slow and
eventually stop the ‘silent epidemic’.

© 2012 John Wiley & Sons A/S.
Full free text

http://onlinelibrary.wiley.com/doi/10.1111/liv.12063/full
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Research fatigue among injecting drug users in Karachi,
Pakistan
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23758666

Harm Reduct J. 2013 Jun 11;10(1):9.

Research fatigue among injecting drug users in Karachi, Pakistan.

Zahidie A, Altaf A, Ahsan A, Jamali T.

BACKGROUND: Karachi is the largest metropolis of Pakistan and its economic
hub attracting domestic migrants for economic opportunities. It is also the
epicenter of HIV epidemic in the country. Since 2004, one pilot study and
four behavioral and biological surveillance rounds have been conducted in
Karachi. In addition many student research projects have also focused on
key risk groups including injection drug users (IDUs). As a result of this
extra ordinary exposure of same kind of questions, IDUs know how to respond
to high value questions related to sharing of needles or unsafe sexual
practices. The purpose of the study was to explore the element of research
fatigue among IDUs in Karachi, Pakistan.

METHODS: The study was conducted on 32 spots in Karachi, selected on the
basis of estimate of IDUs at each spot. A trained field worker (recovered
IDU) visited each spot; observed sharing behavior of IDUs and asked
questions related to practices in January 2009.Verbal consent was obtained
from each respondent before asking questions.

RESULTS: On average 14 IDUs were present at each spot and out of 32
selected spots, 81% were active while more than two groups were present at
69% spots. In each group three to four IDUs were present and everyone in
the group was sharing. One dose of injecting narcotics was observed.
Sharing of syringes, needles and distilled water was observed at 63% spots
while professional injector/street doctor was present at 60% spots.

CONCLUSION: There is a need to check internal consistency in surveillance
research. It is highly likely that IDUs and other risk groups know how to
respond to key questions but their responses do not match with the
practices.

Free full text http://www.harmreductionjournal.com/content/10/1/9
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Reduction in HCV Incidence Among Injection Drug Users
Attending Needle and Syringe Programs in Australia: A Linkage Study
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23763399

Am J Public Health. 2013 Jun 13.

Reduction in HCV Incidence Among Injection Drug Users Attending Needle and
Syringe Programs in Australia: A Linkage Study.

Iversen J, Wand H, Topp L, Kaldor J, Maher L.

Jenny Iversen, Handan Wand, John Kaldor, and Lisa Maher are with the Kirby
Institute, University of New South Wales, Sydney, Australia. Libby Topp is
with Cancer Council NSW, Sydney.

Objectives. We examined trends in HCV incident infection among injection
drug users (IDUs) attending needle and syringe programs (NSPs) in Australia
in 1995 to 2010.

Methods. We created a passive retrospective cohort of 724 IDUs who tested
negative for HCV antibodies by a simple deterministic method linking
partial identifiers to find repeat respondents in annual cross-sectional
serosurveillance.

Results. We identified 180 HCV seroconversions over the study period, for a
pooled incidence density of 17.0 per 100 person-years (95% confidence
interval [CI]?=?14.68, 19.66). Incidence density declined, from a high of
30.8 per 100 person-years (95% CI?=?21.3, 44.6) in 2003 to a low of 4.0
(95% CI?=?1.3, 12.3) in 2009.

Conclusions. A decline in HCV incidence among Australian IDUs attending
NSPs coincided with considerable expansion of harm reduction programs and a
likely reduction in the number of IDUs, associated with significant changes
in drug markets.

Our results demonstrate the capacity of repeat cross- sectional
serosurveillance to monitor trends in HCV incidence and provide a platform
from which to assess the impact of prevention and treatment interventions.
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Law Enforcement Practices Associated with HIV Infection Among
Injection Drug Users in Odessa, Ukraine
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23754613

AIDS Behav. 2013 Jun 11.

Law Enforcement Practices Associated with HIV Infection Among Injection
Drug Users in Odessa, Ukraine.

Booth RE, Dvoryak S, Sung-Joon M, Brewster JT, Wendt WW, Corsi KF, Semerik
OY, Strathdee SA.

Department of Psychiatry, University of Colorado School of Medicine,
Project Safe 1741 Vine Street, Denver, CO, 80206-1119, USA,
Robert.booth@ucdenver.edu.

Despite HIV prevention efforts over the past 10 years in Odessa, Ukraine,
HIV rates among injection drug users (IDUs) remain high. We explored
whether IDUs’ experiences with the police and court system in Odessa were
associated with HIV serostatus, after controlling for other factors.

Qualitative methods, including semi-structured interviews with the police
and members of court (N = 19), and focus groups with IDUs (N = 42), were
employed to aid in developing a survey instrument for a larger quantitative
phase and to assist in interpreting the findings from the quantitative
phase, which included 200 participants who were interviewed and tested for
HIV. Overall, 55 % tested positive for HIV.

Negative experiences with the police were noted by 86 % and included having
preloaded syringes taken (66 %), rushed injections due to fear of the
police (57 %), police planting drugs (18 %), paying police to avoid arrest
(61 %) and threatened by the police to inform on other IDUs (23 %).

HIV positive participants were more likely than those who were negative to
report these experiences. In a multiple logistic regression, the most
significant correlate of HIV infection was rushed injections due to fear of
the police.

Police actions in Odessa may be contributing to the continued escalation of
HIV among IDUs, underscoring the need for structural interventions.
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Update to Interim Guidance for Preexposure Prophylaxis (PrEP)
for the Prevention of HIV Infection: PrEP for Injecting Drug Users
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23760186

MMWR Morb Mortal Wkly Rep. 2013 Jun 14;62(23):463-5.

Update to Interim Guidance for Preexposure Prophylaxis (PrEP) for the
Prevention of HIV Infection: PrEP for Injecting Drug Users.

Centers for Disease Control and Prevention (CDC).

On June 12, 2013, the Thailand Ministry of Health and CDC published results
from a randomized controlled trial of a daily oral dose of 300 mg of
tenofovir disoproxil fumarate (TDF) that showed efficacy in reducing the
acquisition of human immunodeficiency virus (HIV) infection among injecting
drug users (IDUs) (1).

Based on these findings, CDC recommends that preexposure prophylaxis (PrEP)
be considered as one of several prevention options for persons at very high
risk for HIV acquisition through the injection of illicit drugs.

http://www.cdc.gov/mmWr/preview/mmwrhtml/mm6223a2.htm?s_cid=mm6223a2_w
__________________________________________________________________
________________________________*_________________________________

9. Abstract: An alternative local anaesthesia technique to reduce pain in
paediatric patients during needle insertion
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23758459

Eur J Paediatr Dent. 2013 Jun;14(2):109-12.

An alternative local anaesthesia technique to reduce pain in paediatric
patients during needle insertion.

Lee SH, Lee NY.

Department of Pediatric Dentistry, School of Dentistry, Chosun University,
Gwangju, South Korea.

AIM Pain control, which is necessary during most dental procedures, is
administered by injecting a local anaesthetic. Because the injection itself
can be painful, the procedure via which pain is reduced warrants continued
investigation. Only a few studies regarding the reaction of children to
dental needle insertion without the use of topical anaesthetics have been
reported. This study was conducted to evaluate the efficacy of the local
anaesthetic procedure without topical application as compared to the
conventional insertion technique for alleviating pain in children receiving
local anaesthesia injections.

MATERIALS AND METHODS For the alternative injection procedure, the dentist
quickly and gently pulled or pushed the clean and dried loose tissue at the
injection site over the tip of the needle to a depth of 1 to 1.5 mm. When
the end of the bevel of the needle tip entered the tissue, a few drops of
solution were released, after which the needle was advanced to its proper
and intended depth to continue anaesthetic release.

RESULTS There was a significant difference regarding the pain response
between the alternative insertion technique (less painful) and the
conventional one according to Sound, Eye, and Motor (SEM) scale ratings (P
< 0.000). No significant difference was observed in the response between
the maxilla and mandible, nor between boys and girls, between the
conventional and alternative techniques.

CONCLUSION This alternative technique can reduce discomfort in paediatric
dental patients and allow the clinician to administer a superficial local
anaesthesia injection before the needle is advanced into deeper tissue.
This technique is simple, quick, devoid of additional costs, and
potentially more effective than the conventional needle insertion method.
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Occupational hazards of interventional cardiology
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23759715

Cardiovasc Revasc Med. 2013 Jun 8. pii: S1553-8389(13)00082-1.

Occupational hazards of interventional cardiology.

Smilowitz NR, Balter S, Weisz G.

Center for Interventional Vascular Therapy, New-York Presbyterian Hospital,
Columbia University Medical Center, New York, NY 10032, USA.

Complex catheter-based interventions and rising case volumes confer
occupational risks to interventional cardiologists. Despite advances in
technology, modern interventional procedures are performed in a manner
remarkably similar to the techniques pioneered decades ago. Percutaneous
interventions are associated with operator orthopedic injuries, exposures
to blood borne pathogens, and the effects of chronic radiation exposure
from fluoroscopy.

This review highlights the occupational hazards of interventional
procedures and provides a glimpse at the technologies and techniques that
may reduce risks to operators in the catheterization laboratory.

Copyright © 2013 Elsevier Inc. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

11. USA: Multistate Investigation of Suspected Infections Following Steroid
Injections
__________________________________________________________________
http://www.cdc.gov/hai/outbreaks/TN-pharmacy/index.html

Multistate Investigation of Suspected Infections Following Steroid
Injections
Posted June 13, 2013 3 PM ET

At a Glance:
Status: On-going Investigation
Reported Cases: 26
States reporting cases: 4
Recall: Yes
Distribution maps
States reporting cases *

Map showing states with reported cases.
http://www.cdc.gov/hai/outbreaks/TN-pharmacy/index.html
Click here to view larger map.
States that received recalled MPA

States that have received recalled methylprednisolone acetate product from
Main Street Family Pharmacy since December 1, 2012.

This website will be updated on Thursdays by 3pm ET.

Initial Announcement
May 30, 2013
Main Street Family Pharmacy in Tennessee: FDA Alerts Health Care Providers
of Adverse Reactions Associated with Steroid Injections

State, Federal Health Officials Investigate Reports of Adverse Events among
Patients Receiving Methylprednisolone Acetate Injections

Summary of Investigation

This information is preliminary and will be updated as additional details
become available.

June 13, 2013

CDC and FDA have identified the bacteria and fungi cultured from unopened
vials of preservative-free MPA from Main Street Family Pharmacy (MSFP) in
Newbern, TN. These findings are important reminders that healthcare
providers should ensure that all recalled products from MSFP are no longer
in use. In addition, complaints from patients exposed to products from MSFP
should be taken seriously and should be promptly reported to both FDA
MedWatch and the health department.

In addition to the findings above, 4 of the 26 cases meeting the CDC case
definition* have had bacteria or fungi detected from wounds: 2 patients had
Enterobacter cloacae and Klebsiella pneumoniae, 1 had mixed bacterial
culture not otherwise identified, and 1 had fungus highly suggestive of an
Aspergillus sp., although further studies are needed for confirmation.

Although bacteria and fungi have been isolated from unopened vials of MPA
from MSFP, it is not possible to determine which infections are due to this
contamination event versus other factors including improper handling and/or
administration of medications at the injection facility.

Clinicians are reminded that they should 1) use individual containers of
compounded or preservative-free medicine for a single-patient only, and 2)
promptly report to MedWatch any infection that might be related to a
medication or medical device, even absent a recognized outbreak, as these
reports can allow for early detection of a possible contamination event.

Note: The next CDC web update is scheduled for Thursday, June 20.

June 10, 2013

As of June 10th, CDC is reporting 25 cases from four states – Arkansas,
Florida, Illinois, and North Carolina. See further details below.

June 6, 2013

Suspected infections have occurred among persons who received either
80mg/mL or 40mg/mL of preservative-free methylprednisolone acetate (MPA)
produced by the Main Street Family Pharmacy in Newbern, Tennessee. As of
June 6th, CDC is reporting 24 cases from four states – Arkansas, Florida,
Illinois, North Carolina. The majority of these persons developed skin and
soft tissue infections of unclear etiology following intramuscular
injection of this product. All products labeled as sterile have been
voluntarily recalled by the pharmacy.

State and local health departments are working with facilities to verify
the accuracy of the pharmacy’s distribution records and to determine which
patients may require active outreach. Healthcare providers are contacting
patients to determine if they have had possible infections stemming from
injections of recalled MPA. Suspected infections that meet the criteria
below* are reflected in the case count presented on this webpage.
Healthcare providers are reminded that any adverse reaction following
injection with a recalled product from Main Street Family Pharmacy should
be reported to FDA’s Medwatch system, which is designed to routinely
collect these types of reports.

On June 6, FDA reported detection of microbial contamination, including
bacterial and fungal, in unopened vials of preservative-free MPA. Samples
are being sent to CDC for further characterization. These findings
emphasize the importance for providers to continue to ensure that all
recalled products are no longer in use and returned promptly. Clinicians
are also reminded that individual containers of compounded or preservative
free medicine are intended for single-patient use only; they should not be
used as a common source of supply for multiple patients.

CDC is working closely with FDA and the health departments in affected
states to monitor and to evaluate this situation. We will provide more
information as it becomes available.

*Case Definition: A person who developed a suspected infection associated
with injection of a product, labeled as sterile, that was distributed by
the Main Street Family Pharmacy (Newbern, TN) since December 1, 2012.

June 3, 2013

CDC is aware of reports of suspected infections among persons who received
either 80mg/mL or 40mg/mL of preservative-free methylprednisolone acetate
(MPA) produced by the Main Street Family Pharmacy in Newbern, Tennessee. As
of June 3rd, CDC is aware of 24 reported cases from four states – Arkansas,
Florida , Illinois, North Carolina. The majority of these persons
developed skin and soft tissue infections of unclear etiology following
intramuscular injection of this product. Additional clinical information is
being gathered. To date, no reports of meningitis or other life-
threatening infections have been reported. All products labeled as sterile
have been voluntarily recalled by the pharmacy. CDC is not aware of
infections among persons who received products other than preservative-free
MPA in the above formulation from this pharmacy. State and local health
departments are working with CDC and FDA to evaluate this situation.

*Case Definition: A person who developed a suspected infection associated
with injection of a product, labeled as sterile, that was distributed by
the Main Street Family Pharmacy (Newbern, TN) since December 1, 2012.
__________________________________________________________________
________________________________*_________________________________

12. News

– Got Needles? Why the Greatest Danger to Law Enforcement Isn’t Guns
– Assam India: Criminal case against transfusion of HIV-infected blood:
Gogoi
– Italy: Italy leads Europe in hepatitis C cases

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
http://tinyurl.com/knatwkq

Got Needles? Why the Greatest Danger to Law Enforcement Isn’t Guns

Tessie Castillo, Advocacy and Communications Coordinator, North Carolina
Harm Reduction Coalition, in Huffington Post (17.06.13)

When most people imagine the dangers that law enforcement officers face,
they picture high-drama action scenes from Law & Order or CSI — drug busts
where bullets spray from behind a locked door; heart-thumping alley chases
where any number of hooded suspects lurk in the shadows; a routine traffic
stop where, instead of a license, the officer encounters the cold muzzle of
a gun. But while only one in 50,000 officers in the United States is killed
by a firearm during the course of duty, one in three, according to a study
in the American Journal of Preventative Medicine, will suffer wounds from a
less glitzy, but far more common foe: syringes.

Needle-stick injury, or being punctured by used syringes that could be
contaminated with dangerous viruses such as HIV or hepatitis C, is a common
occupational hazard for law enforcement. The injuries typically occur as
the officer searches a suspect’s pockets or belongings. Although officers
are encouraged to ask a suspect prior to search if he or she possesses
needles or sharp objects, in most states fear of paraphernalia charges
leads many suspects to lie or attempt to hide the objects, thereby
increasing the risk of a needle-stick to the officer.

Officer Jen “Crash” Earls, now retired from the Chicago Police Department,
had just pulled over a posh Lexus after the driver had sped through a red
light.

“My license is in my purse,” the woman told her. Without thinking, Officer
Earls reached into the purse — and stuck her hand on seven dirty heroin
needles.

“Getting stuck by a needle was one of the scariest moments of my career,”
says Officer Earls. “I didn’t know the syringes were there, and I didn’t
know if [the woman] had HIV or viral hepatitis.”

Officer Earls didn’t tell anyone she’d been stuck, as she didn’t want to
admit to a “rookie mistake” or draw negative attention to herself. She was
lucky not to catch a virus. Other less fortunate officers who are exposed
to disease (60-80 percent of injection drug users have hepatitis C and 9
percent of new HIV cases come from syringe sharing) have to endure post-
exposure prophylaxis treatment, a chemo-like regimen of harsh chemicals
that put the officer out of work for months and are costly to departments.
The treatment is designed to prevent viral transmission after an exposure.

Some cities and states have taken steps to protect law enforcement from
accidental needle-sticks by decriminalizing syringes, or removing them from
the list of paraphernalia. Suspects are more likely to be honest with
officers about syringe possession if they don’t fear legal repercussions.
According to a CDC study, needle-stick injuries to law enforcement plummet
by an impressive 66 percent when syringes are decriminalized.

Today North Carolina becomes the newest state to enact a partial syringe
decriminalization law, HB850 Possession of Needles/Tell Law Officer. The
law is the first of its kind in the nation to specifically address the
issue of law enforcement safety through amending the paraphernalia
statutes. Under the new law, if an officer asks a person prior to search if
he or she is carrying syringes or other sharp objects, and the person
discloses their location, he or she is not subject to prosecution for
possession of those objects.

“This bill is about opening up honest dialogue between law enforcement
officers and the people they come in contact with,” says Detective Ronald
Martin, retired from over 20 years service to the New York City Police
Department and an advocate for HB850. “When people are afraid of us and
hiding things from us, it puts everyone at greater risk.”

HB850’s principle advocate was the North Carolina Harm Reduction Coalition
(NCHRC), a public health organization that has trained over 1000 law
enforcement officers in North and South Carolina on how to avoid needle-
stick injuries and reduce disease transmission.

“This law is important to protect law enforcement officers from contact
with deadly viruses such as HIV or hepatitis C,” says Robert Childs,
Executive Director of NCHRC. “People don’t often think about the dangers of
contracting diseases during a search, but we need to recognize that this is
a critical issue for law enforcement. These brave men and women protect our
communities and we should return that favor by protecting them from
disease.”

Learn more about needle-stick injuries to law enforcement
www.nchrc.org/law-enforcement/safety-tools-for-officers-and-resources/

or how syringe decriminalization can help increase officer safety
www.amfar.org/uploadedFiles/In_the_Community/Publications/factsheetJan2010.
pdf
http://tinyurl.com/kp3gydz
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/kf4tfnm

Assam India: Criminal case against transfusion of HIV-infected blood: Gogoi

Times of India, Agencies (15.06.13)

Assam Chief Minister Tarun Gogoi has directed that a criminal case be
registered on the incident of transfusion of HIV-infected blood to four
patients at Darrang Civil Hospital. A high-level medical team from the
Gauhati Medical College Hospital along with Drugs Control and AIDS Control
officials are in the hospital today to investigate the incident.

“I have asked the authorities to register a criminal case in this incident.
The incident is very unfortunate and we have taken it very very seriously”,
Gogoi told reporters here. “I have ordered a complete inspection of all the
government and private blood banks in the state”, the Chief Minister said.

“I would not like to blame the Health Ministry, but only a few officers may
be responsible. I have ordered an inquiry into the incident and we will
take action”, he said. “We have to compensate the victims. They are our
people and it is the government’s responsibility to take care of them,”
Gogoi added.

The exact number of victims infected by the tainted blood was not yet known
as the doctors were examining the patients. An official statement yesterday
had said four patients had been infected and Gogoi has ordered an inquiry
into the incident. Unofficial sources, however, put the number at ten.

Meanwhile, the high-level team, including the head of the departments of
Pathology and Haematology from the GMCH, were probing the incident.

Meanwhile, agitated locals blocked NH 52 disrupting traffic for several
hours in protest against the incident. The hospital authorities told the
team that the alleged victims were old cases of AIDS infection and that
they always conduct mandatory tests on donated blood for HIV virus before
transfusion.

The locals claimed that a person enlisted as a voluntary blood donor and
HIV positive was donating blood at the blood bank of the Civil Hospital.

The four allegedly affected persons were admitted to the hospital at
different times last year and given infected blood from the blood bank
there, they added.
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http://tinyurl.com/kjr2dsj

Italy: Italy leads Europe in hepatitis C cases

Gazzetta del Sud, Italy (11.06.13)

Some 3% of population infected, over half with the worst kind

Milan, June 11 – Italy leads Europe in cases of hepatitis C with 3% of the
population infected, more than half of whom suffer from the most difficult
variety to treat, leading experts said Tuesday.

Some 1.6 million people carry the liver infection in Italy and 55% of them
are afflicted with genotype 1, a particularly infectious strain of the
disease, said doctors at the Premio Giornalistico Riccardo Tomassetti
conference on virology in Milan.

“At least one million Italians are chronic carriers of the infection,” said
Massimo Colombo, director of special treatments and organ transplants at
Milan’s Maggiore hospital. “One third of these people have developed or are
developing serious liver infections”.

The majority of patients contracted the virus in the 1970s and 80s, Colombo
said, with infected blood transfusions, or from health instruments such as
hypodermic needles that were not sterilized.

“But another 200-300,000 contracted the disease due to risky behaviour such
as unprotected sex, piercings and tattoos. “In addition we should include
a substantial number of migrants who come from areas with high levels of
hepatitis C”.
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The 2010 annual Safe Injection Global Network meeting to aid collaboration
and synergy among SIGN network participants worldwide was held from 9
to 11 November 2010 in Dubai, The United Arab Emirates.

The SIGN 2010 meeting report pdf, 1.36Mb is available on line at:
http://www.who.int/injection_safety/toolbox/sign2010_meeting.pdf

The report is navigable using bookmarks and is searchable. Viewing
requires the free Adobe Acrobat Reader at: http://get.adobe.com/reader/

Translation tools are available at: http://www.google.com/language_tools
or http://www.freetranslation.com
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